2025 CPT code 22226
(Active) Effective Date: N/A Surgery - Musculoskeletal System Feed
Each additional vertebral segment (List separately in addition to code for primary procedure) during osteotomy of spine, including diskectomy, anterior approach.
Modifier 62 may be applicable when two surgeons work together as primary surgeons performing distinct parts of the procedure.
Medical necessity for this procedure must be clearly established through documentation of failed conservative treatment, imaging evidence of spinal deformity affecting nerve function, and correlation of symptoms with the level of intervention.
The surgeon exposes the lamina and intervertebral disc space at the additional vertebral segment. Soft tissues are reflected subperiosteally from the adjacent vertebrae, and bone cutting instruments are used to remove the adjacent disc material.A wedge-shaped piece of bone is excised from the vertebral body at its midportion.
In simple words: This code is used when a surgeon operates on more than one section of the spine during a procedure to correct its alignment, by removing bone and disc material from the front of the spine. It's used in addition to the code for the main part of the operation.
This code describes the surgical procedure performed on each additional vertebral segment during an osteotomy of the spine, including diskectomy, using an anterior approach.It is reported in addition to the primary procedure code (22220, 22222, or 22224).
Example 1: A patient with scoliosis undergoes an anterior osteotomy and discectomy at L3-L4. An additional segment, L4-L5, also requires the procedure. Code 22226 is reported in addition to the primary procedure code., A patient with kyphosis requires an anterior osteotomy and discectomy at two vertebral segments, T11-T12 and T12-L1.Code 22226 is reported for the work at T12-L1., A patient has a spinal deformity following a traumatic injury, requiring an anterior osteotomy and discectomy at three levels, C5-C6, C6-C7, and C7-T1. Code 22226 is reported twice, once for the C6-C7 segment and once for C7-T1, in addition to the primary procedure code for C5-C6.
Documentation should include the diagnosis, the specific vertebral levels treated, the operative approach (anterior), the type of osteotomy performed, and any associated procedures like discectomy. Pre- and post-operative imaging studies should be documented, and any complications should be noted.
- Payment Status: Active
- Specialties:Orthopedic Surgery, Neurosurgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center